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What does the following treadmill stress test result indicate?

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Posted on Fri, 18 Sep 2015
Question: Hi, (I was having chest tightness, shortness of breath for more than 10 years). Lately i went to see cardiolgist.
i just got "Treadmill Stress Test" results & the result is as below.
-> lead II first exhibited ST depression excedding 1 mm at 04:40 exercise
-> ST depression exceeded 1 mm for 02:30 mins
-> 2.5mm XXXXXXX depression in II was exhibited at 07:20 mins of exercise
-> At 0:39 of recovery ST segment returned to baseline

The doctor scheduled angiogram in next few weeks. What kind of results i can expect based on the above result of "Treadmill Stress Test".He did not say whether it is ST depression uplsope/downslope/horizontal.
ST depression of 2.5mm means i had the blockage ?? Because that is what my doctor said.
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Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
I would explain as follows:

Detailed Answer:

Hello!

Welcome and thank you for asking on HCM!

Regarding your treadmill stress test, I would like to explain that judging from the degree of ST depression on lead II a probable cardiac ischemia may be present.

But, the above finding needs to be associated with other consecutive leads abnormalities in order to increase specificity.

As you declared, we haven't information about morphology of ST deviation (up-sloping/down-sloping/horizontal) to differentiate from nonspecific changes.

When ST depressions are found on the inferior leads during stress testing, when non-proportional concomitant very high blood pressure is present, specificity for induced myocardial ischemia is insufficient.

In such case coupled ST abnormality on precordial leads (such as V5-V6), would improve specificity and be a more reliable indicator of induced cardiac ischemia.

For an optimal professional opinion, it is necessary also information about clinical symptomatology (chest pain, or any pain equivalents), hemodynamic response during exertion and recovery periods (respective BP values), possible conductance and arrhythmic disturbances, and exercise capacity.

If you could upload you full treadmill stress test, I could give a more accurate opinion.

Even when concluded as positive result, a stress test lacks sufficient specificity, if only a single lead abnormality is revealed (such as in your case DII), and no other abnormality is observed (the above mentioned variables).

So, to conclude I would explain that, besides the non absolute specificity inherent in cardiac stress test accuracy, your actual provided treadmill stress test data are insufficient to draw an accurate conclusion about a clear cardiac ischemia response.

Additional imagine modalities incorporated to cardiac stress testing yield a higher sensibility and specificity for discriminating myocardial ischemia.

As you have already performed coronary angiography, no further exams are necessary.

You just need to wait for the results.

Meanwhile you shouldn’t worry about a possible coronary lesion confirmation, as you are just in time to prevent any complications by treating in advance.

Hope to have been helpful to you!

If you have any further uncertainties, do not hesitate to contact me!

Wishing you good health!

Greetings! Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 8715 Questions

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What does the following treadmill stress test result indicate?

Brief Answer: I would explain as follows: Detailed Answer: Hello! Welcome and thank you for asking on HCM! Regarding your treadmill stress test, I would like to explain that judging from the degree of ST depression on lead II a probable cardiac ischemia may be present. But, the above finding needs to be associated with other consecutive leads abnormalities in order to increase specificity. As you declared, we haven't information about morphology of ST deviation (up-sloping/down-sloping/horizontal) to differentiate from nonspecific changes. When ST depressions are found on the inferior leads during stress testing, when non-proportional concomitant very high blood pressure is present, specificity for induced myocardial ischemia is insufficient. In such case coupled ST abnormality on precordial leads (such as V5-V6), would improve specificity and be a more reliable indicator of induced cardiac ischemia. For an optimal professional opinion, it is necessary also information about clinical symptomatology (chest pain, or any pain equivalents), hemodynamic response during exertion and recovery periods (respective BP values), possible conductance and arrhythmic disturbances, and exercise capacity. If you could upload you full treadmill stress test, I could give a more accurate opinion. Even when concluded as positive result, a stress test lacks sufficient specificity, if only a single lead abnormality is revealed (such as in your case DII), and no other abnormality is observed (the above mentioned variables). So, to conclude I would explain that, besides the non absolute specificity inherent in cardiac stress test accuracy, your actual provided treadmill stress test data are insufficient to draw an accurate conclusion about a clear cardiac ischemia response. Additional imagine modalities incorporated to cardiac stress testing yield a higher sensibility and specificity for discriminating myocardial ischemia. As you have already performed coronary angiography, no further exams are necessary. You just need to wait for the results. Meanwhile you shouldn’t worry about a possible coronary lesion confirmation, as you are just in time to prevent any complications by treating in advance. Hope to have been helpful to you! If you have any further uncertainties, do not hesitate to contact me! Wishing you good health! Greetings! Dr. Iliri